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Activated protein C-protein C inhibitor complex: a new biological marker for aortic aneurysms.

Kölbel, Tilo LU ; Strandberg, Karin LU ; Mattiasson, Ingrid LU ; Stenflo, Johan LU and Lindblad, Bengt LU (2006) In Journal of Vascular Surgery 43(5). p.935-939
Abstract
Objective: The concentration of the complex between activated protein C (APC) and protein C inhibitor (PCI) is a measure of thrombin generation. We studied whether it can provide information useful for the diagnosis and treatment of arterial vascular disease. Methods: Blood was obtained from 429 vascular patients admitted consecutively during September 2004 to March 2005. The APC-PCI complex was measured by using a sandwich immunofluorometric method. The patients were divided into cohorts according to the planned treatment and compared with a control group of healthy individuals. Results: The APC-PCI complex concentration varied from 0.08 to 2.50 mu g/L. In the cohort of patients with aortic aneurysms (n = 78), the median APC-PCI value was... (More)
Objective: The concentration of the complex between activated protein C (APC) and protein C inhibitor (PCI) is a measure of thrombin generation. We studied whether it can provide information useful for the diagnosis and treatment of arterial vascular disease. Methods: Blood was obtained from 429 vascular patients admitted consecutively during September 2004 to March 2005. The APC-PCI complex was measured by using a sandwich immunofluorometric method. The patients were divided into cohorts according to the planned treatment and compared with a control group of healthy individuals. Results: The APC-PCI complex concentration varied from 0.08 to 2.50 mu g/L. In the cohort of patients with aortic aneurysms (n = 78), the median APC-PCI value was 0.45 (10(th) to 90(th) percentile, 0.24-1.47), and values were clearly increased compared with all other cohorts (P <.0001). Patients with carotid disease (n = 73) yielded a median of 0.22 (10(th) to 90(th) percentile, 0.15-0.48). The median for claudicants (n = 74) was 0.26 mu g/L (10(th) to 90(th) percentile, 0.15-0.75), which was higher than in those (n = 97) with critical ischemia (0.20; 10(th) to 90(th) percentile, 0.13-0.36; P <.0023). The cohort with other forms of antherosclerotic disease (n = 40) had a median of 0.23 (10(th) to 90(th) percentile, 0.14-0.42), whereas the value for a cohort of 21 patients with venous disease was 0.19 (10(th) to 90(th) percentile, 0.10-0.34). The median was 0.15 (10(th) to 90(th) percentile, 0.10-0.23) for the control group (n = 121). Conclusions: Patients with atherosclerosis had an increased APC-PCI concentration that corresponded to increased generation of thrombin. Patients with aortic aneurysm had a threefold higher median concentration than the control group. We suggest that this remarkable increase is caused by the local activation of coagulation, and we surmise that APC-PCI measurements can be used as a screening tool to identify patients with aortic aneurysms. (Less)
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keywords
Aortic Aneurysm, 80 and over, Intermittent Claudication: blood, Humans, Female, Enzyme Activation, Cohort Studies, Carotid Stenosis: diagnosis, Carotid Stenosis: blood, Biological Markers: blood, Atherosclerosis: diagnosis, Atherosclerosis: blood, Abdominal: diagnosis, Abdominal: blood, Aged, Adult, Intermittent Claudication: diagnosis, Ischemia: diagnosis, Ischemia: blood, Leg: blood supply, Male, Mass Screening, Middle Aged, Predictive Value of Tests, Protein C: metabolism, Protein C Inhibitor: blood, Reference Values, Research Support, Non-U.S. Gov't, Statistics, Thrombin: metabolism
in
Journal of Vascular Surgery
volume
43
issue
5
pages
935 - 939
publisher
Mosby
external identifiers
  • wos:000237261400013
  • pmid:16678686
  • scopus:33646137368
  • pmid:16678686
ISSN
1097-6809
DOI
10.1016/j.jvs.2006.01.019
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Unit for Clinical Vascular Disease Research (013242410), Clinical Chemistry, Malmö (013016000), Emergency medicine/Medicine/Surgery (013240200)
id
3f8a36db-cb0c-47c4-be72-18b7e4988d8f (old id 156967)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16678686&dopt=Abstract
date added to LUP
2016-04-01 15:51:49
date last changed
2021-10-06 03:42:40
@article{3f8a36db-cb0c-47c4-be72-18b7e4988d8f,
  abstract     = {Objective: The concentration of the complex between activated protein C (APC) and protein C inhibitor (PCI) is a measure of thrombin generation. We studied whether it can provide information useful for the diagnosis and treatment of arterial vascular disease. Methods: Blood was obtained from 429 vascular patients admitted consecutively during September 2004 to March 2005. The APC-PCI complex was measured by using a sandwich immunofluorometric method. The patients were divided into cohorts according to the planned treatment and compared with a control group of healthy individuals. Results: The APC-PCI complex concentration varied from 0.08 to 2.50 mu g/L. In the cohort of patients with aortic aneurysms (n = 78), the median APC-PCI value was 0.45 (10(th) to 90(th) percentile, 0.24-1.47), and values were clearly increased compared with all other cohorts (P &lt;.0001). Patients with carotid disease (n = 73) yielded a median of 0.22 (10(th) to 90(th) percentile, 0.15-0.48). The median for claudicants (n = 74) was 0.26 mu g/L (10(th) to 90(th) percentile, 0.15-0.75), which was higher than in those (n = 97) with critical ischemia (0.20; 10(th) to 90(th) percentile, 0.13-0.36; P &lt;.0023). The cohort with other forms of antherosclerotic disease (n = 40) had a median of 0.23 (10(th) to 90(th) percentile, 0.14-0.42), whereas the value for a cohort of 21 patients with venous disease was 0.19 (10(th) to 90(th) percentile, 0.10-0.34). The median was 0.15 (10(th) to 90(th) percentile, 0.10-0.23) for the control group (n = 121). Conclusions: Patients with atherosclerosis had an increased APC-PCI concentration that corresponded to increased generation of thrombin. Patients with aortic aneurysm had a threefold higher median concentration than the control group. We suggest that this remarkable increase is caused by the local activation of coagulation, and we surmise that APC-PCI measurements can be used as a screening tool to identify patients with aortic aneurysms.},
  author       = {Kölbel, Tilo and Strandberg, Karin and Mattiasson, Ingrid and Stenflo, Johan and Lindblad, Bengt},
  issn         = {1097-6809},
  language     = {eng},
  number       = {5},
  pages        = {935--939},
  publisher    = {Mosby},
  series       = {Journal of Vascular Surgery},
  title        = {Activated protein C-protein C inhibitor complex: a new biological marker for aortic aneurysms.},
  url          = {http://dx.doi.org/10.1016/j.jvs.2006.01.019},
  doi          = {10.1016/j.jvs.2006.01.019},
  volume       = {43},
  year         = {2006},
}